N.P. Kirbasova¹, N.A. Kravchenko¹, R.A. Khalfin¹, A.M. Magomedova², P.M. Nurmagomedova³
Substantiating the need for obstetric beds in the Republic of Dagestan with due regard to demographic and geographic peculiarities of the territory
¹I.M. Sechenov First Moscow State Medical University, Moscow
²Medical stock insurance company «Max-M», Makhachkala Branch, Republic of Dagestan
³Ministry of Health, Makhachkala, Republic of Dagestan 

Summary. Background. The existing two-level structure of the obstetric facilities’ network in the Republic of Dagestan fails to meet regulatory documents of the Russian Federation stemming decline in maternal and perinatal mortality as well as limiting availability and decreasing quality of care to pregnant women, parturient women and newborns. Those indicators exceed the ones in the Russian Fedearation by 1.5-1.9 times. Increase in early neonatal mortality accounts for a slow rate of perinatal mortality reduction. 21-26% of deliveries occur in rural areas; 68% of maternal deaths are registered among rural women.

The authors substantiate the need for increasing the number of obstetric beds based on maternal and perinatal mortality indicators, geographical location and transportation routes in the Republic. The authors also identify three territorial zones for allocating the missing beds (third level beds). The authors also suggest methods for calculating population need in obstetric beds.

The aim of the study was to substantiate methodology for calculating need in obstetric beds.

Methods: the authors analyzed demographic structure of the population, fertility, maternal and perinatal mortality on the base of “Dagestanstat” official statistics.

Results: methodology for calculating need in obstetric beds was developed.

Conclusions:

1. The two-level structure of obstetric facilities network stems decline in maternal and perinatal mortality; limits access to care.

2. The need for optimizing obstetric facilities network in terms of capacity and structure was substantiated: the new three-level system of obstetric care is under development.

3. The missing third-level beds are to be allocated within the three medical territorial zones: Derbent – 184 beds, Makhachkala – 406 beds and Khasaviurt – 188 beds.

Scope of application: territorial Program on optimizing obstetric facilities’ network, territorial Programme on State Guarantees.

Keywords: population need in obstetric beds; maternal mortality; perinatal mortality; fertility; demographic structure of population; calculation of need in beds; geographical peculiarities.

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